Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroidal vasculopathy: one-year follow-up

Mario R Romano¹, Ugo Cipollone², Francesco Semeraro³, Michele Rinaldi⁴, Ciro Costagliola^1
1Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso; ²Dipartimento di Oftalmologia, Ospedale G Vietri, Larino, Campobasso; ³Clinica Oculistica, Università degli Studi di Brescia, Brescia; ⁴Clinica Oculistica, II Università degli Studi di Napoli, Napoli, Italy

Objective: To report the efficacy and safety of combined photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection in the treatment of idiopathic polypoidal choroidal vasculopathy (IPCV).
Material and methods: A prospective case series of 10 eyes of 10 consecutive patients affected by IPCV with subfoveal involvement. PDT plus IVB (1.25 mg/0.05 mL) injection two weeks later was performed in all patients. Two adjunctive injections of bevacizumab were scheduled at four and eight weeks after the initial treatment. Best-corrected visual acuity (BCVA), fluorescein and indocyanine green angiographies, and optical coherence tomography were obtained at baseline, and at one, three, six, nine, and 12 months.
Results: The combined treatment led to an improvement of both neurosensory detachment and pigmented epithelial detachment in all eyes, with a decrease of exudation and regression of macular thickness, which remained stable to the end of follow-up. However, BCVA remained stable over the 12 months of follow-up.
Conclusion: These findings demonstrate that PDT/IVB combined therapy is able to achieve morphologic stabilization of the IPCV lesion, through a rapid decrease of macular thickness and regression of the size of polypoidal vascular lesion.

Keywords: combined treatment, idiopathic polypoidal choroidal vasculopathy, age-related macular degeneration, intravitreal bevacizumab, photodynamic therapy